This R21 grant is designed to develop and facilitate collaborative research capabilites for studies on age-related cognitive loss at the TN Medical College/ Nair Hospital in Mumbai (Bombay), India, working in conjunction with the Mount Sinai School of Medicine Alzheimer's Disease Research Center (ADRC). This collaboration will involve experienced senior faculty at Mount Sinai who have long experience in research on Alzheimer's disease and other age-related neurodegenerative diseases. We propose to work with Dr. Charles Pinto, Professor of Psychiatry at the TN Medical College, one of the few Indian medical academic figures who has initiated an ongoing research program on age-related cognitive disorders. The targeted population for this collaborative study lives in Mumbai (Bombay), one of the largest urban populations in the world. The proposed research collaboration is of particular importance when one recognizes that India, the second most populous country in the developing world, has a very rapidly growing elderly population. We propose to modify existing screening instruments to be practical and culturally appropriate and use them to identify cases with impaired cognitive function. We will also assist in developing and implimenting culturally appropriate neuropsychological cognitive assessment tools and clinical diagnostic protocols for use in dementia research at the TN Medical College. Personnel at the TN Medical College will be trained in using these assessment instruments and generating data on cognitive function in a standardized fashion. Capacity for modern database operation with computerized data entry and storage will also be achieved. We will assist in the creation of the infrastructure and procedures needed to establish a Brain Bank facility in Mumbai. Using this facility, we will collect brains from elderly individuals coming to autopsy and evaluate them for the extent and distribution of Alzheimer's disease-related lesions. These specimens will be compared to age-matched specimens derived from New York to determine if there are differences in the tendency to develop such lesions in the two populations. The capabilities and preliminary data emerging from this R21 grant will be used to organize a proposal for more long-term studies of age-related cognitive loss in Mumbai utilizing the collaborative arrangements developed through the work of the current proposal. We anticipate that these studies will emphasize cliniconeuropathologic investigations in parallel with ongoing research at the Mount Sinai ADRC.